[mahyarm]

I don't work at basecamp, but in practice it's pressing the ack button on pager duty on my phone, looking at the alert metrics to see if it's something I should worry about immediately and if it is and I'm not available, I would go ask someone else to try to deal with it. Oncall is triage, you usually ping the person actually responsible for it.

And if I am surprisingly indisposed it would fall back to everyone else. If I need to go to the doctor, then I would swap times with someone else. No one has gotten fired for letting an alert through, just minorly teased the next day.